Problem #5

Susan is a 16 YOWF who has been admitted to the hospital for "clean out" and re-education secondary to a diagnosis of cystic fibrosis. She was diagnosed at three months by a sweat teast after displaying failure to thrive. Susan attends public school and is in the tenth grade. She plays the piano well and is academically a good student. She is an only child who lives with her mother, and reportedly has an active parent-child relationship with her father.

Subjective:

• -Medication routinely taken at home: Theophyline, pancrease, megavitamins, keflex
• -Susan is excused from physical education class secondary to her illness
• -Susan's mother reports responsibility for performing postural drainage

Objective:

• -PaO2 is 72, PaCO2 is 44
• -increased AP diameter of the chest
• -increased use of accessory musles used during respiration
• -respiratory rate at rest: 32
• -diffuse rales, wheezing, and rhonchi noted on auscultation (especially L lower lobe)
• -Susan was able to AMB 80 feet before complaint of SOB and observable increased respiratory rate to 50

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